Results from a randomised controlled trial (RCT) published in Health Technology Assessment do not support the use of negative-pressure wound therapy (NPWT) in patients undergoing surgery for major trauma to the lower limbs.
In a multicentre RCT, 1548 adults across 24 specialist trauma hospitals in the UK were randomly assigned to incisional NPWT group (n=785) or standard dressings not involving negative pressure (n=763).
There was no difference in the rate of deep surgical site infection at 30 days between the standard dressing group and the incisional NPWT group (6.7% and 5.8%, respectively; OR, 0.87; P=.52). Similarly, there was no difference at 90 days between the standard dressing group and the incisional NPWT group (13.2% and 11.4%, respectively; OR, 0.84; P=.32).
Other outcomes including disability, health-related quality of life and scar healing at three or six months after surgery were comparable between the two groups. Since the unit cost of incisional NPWT group was nearly a hundred times higher than that of standard dressing, it did not reduce the overall cost of treatment.
The authors commented: "Our work suggests that the use of incisional NPWT dressings in other at-risk surgical wounds requires further investigation. Future research may also investigate different approaches to reduce postoperative infections, for example, the use of topical antibiotic preparations in surgical wounds and the role of orthopaedic implants with antimicrobial coatings when fixing the associated fracture."
